Artery Reabsorption & Trigeminal Neuralgia

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Discussion Overview

The discussion centers on the potential for veins or arteries to be reabsorbed or prompted to grow elsewhere, particularly in the context of trigeminal neuralgia, a painful condition often linked to arterial compression of the trigeminal nerve. Participants explore the implications of surgical interventions and the adaptability of vascular structures.

Discussion Character

  • Exploratory
  • Technical explanation
  • Debate/contested

Main Points Raised

  • One participant inquires whether arteries can be prompted to shrink and be reabsorbed if an alternative route is created.
  • Another participant explains that arteries can adapt their caliber and realign through collateral perfusion, but this process is slow and not applicable to trigeminal neuralgia.
  • There is mention of a surgical approach where muscle tissue is interposed between the nerve and the artery, which may provide relief but is not guaranteed.
  • Concerns are raised about the risks of cutting or ligating arteries near the brain, as it could lead to necrosis.
  • One participant expresses skepticism about the feasibility of promoting artery growth in a different location to alleviate compression on the trigeminal nerve.
  • There is a discussion about the limited funding for research on rare diseases like trigeminal neuralgia and ALS, highlighting concerns about the prioritization of research efforts.

Areas of Agreement / Disagreement

Participants do not reach a consensus on the possibility of artery reabsorption or growth. There are competing views regarding the adaptability of arteries and the effectiveness of surgical interventions.

Contextual Notes

The discussion includes assumptions about the biological processes involved in vascular adaptation and the implications of surgical techniques, which remain unresolved. The potential for collateral circulation and the specific challenges related to trigeminal neuralgia are noted but not fully explored.

LightningInAJar
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TL;DR
Do arteries or veins reabsorb if alternate route is created?
I was curious if veins or arteries are ever reabsorbed or can be prompted to? I have been reading into trigeminal neuralgia which is an agonizing condition that leads many people who get it to committ suicide. Often it is the result of an artery pressing on the trigeminal nerve and gradually stripping the myelin sheath away putting direct pressure on the nerve with every heartbeat. Brain surgery is an option but is risky and will sometimes fail to help. I was wondering since an artery can't simply be snipped without causing brain damage. Can an artery be prompted to grow elsewhere so that the troubling one might shrink and be reabsorbed?
 
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LightningInAJar said:
Summary: Do arteries or veins reabsorb if alternate route is created?

I have been reading into trigeminal neuralgia
Links?

LightningInAJar said:
Brain surgery is an option but is risky and will sometimes fail to help.
Links?
 
Arteries do adapt their calibre to the blood flow they're handling, and can realign. It's called collateral perfusion. And it's a not-so-rare finding in coronary heart disease, where occluded arteries are "circumvented" by other vessels, or the regions behind them are supplied from other branches of the coronaries.

But this wouldn't be an option with trigeminal neuralgia.

The formation of collaterals is a slow process, and requires some... ...training, and adaption time. (Also, new arteries are "upscaled" from smaller vessels when you train a muscle). Cutting or ligating or embolizing an artery all of a sudden causes necrosis - which is btw a procedure sometimes used in palliative cancer care, to reduce the size of a tumor or metastasis. So it's a no-go anywhere close to the brain. Or the eyes. Or...

Also, I do know there's a surgical approach to trigeminal neuralgia, where a bit of muscle tissue is interposed between the nerve and the artery suspected / presumed to be compressing it. It often enough works, but it's no 100% thing. So, killing off potentially essential vessels in an attempt to remove a probable cause for another problem isn't the optimal approach. Might be considered as a second- or third-line therapy, but I'm not aware of that. But I'm neither a neurosurgeon nor an oral/maxillofacial specialist.

I quote from
LightningInAJar said:
Longest lasting surgery for it when it succeeds.
https://www.upmc.com/services/neurosurgery/brain/treatments/microvascular-decompression
[Begin quote]
Microvascular decompression provides:
  • Immediate, complete relief in 82 percent of current patients treated
  • Partial relief, requiring occasional or low-dose medication, in 16 percent of current patients treated
One year after surgery:
  • 75 percent of patients continue to enjoy complete pain relief
  • 8 percent have partial relief
Major complications occur in fewer than 5 percent of cases.
[End quote]

And this is the cushion technique. Just with a teflon pad instead of a bit of muscle...
 
Godot_ said:
Arteries do adapt their calibre to the blood flow they're handling, and can realign. It's called collateral perfusion. And it's a not-so-rare finding in coronary heart disease, where occluded arteries are "circumvented" by other vessels, or the regions behind them are supplied from other branches of the coronaries.

But this wouldn't be an option with trigeminal neuralgia.

The formation of collaterals is a slow process, and requires some... ...training, and adaption time. (Also, new arteries are "upscaled" from smaller vessels when you train a muscle). Cutting or ligating or embolizing an artery all of a sudden causes necrosis - which is btw a procedure sometimes used in palliative cancer care, to reduce the size of a tumor or metastasis. So it's a no-go anywhere close to the brain. Or the eyes. Or...

Also, I do know there's a surgical approach to trigeminal neuralgia, where a bit of muscle tissue is interposed between the nerve and the artery suspected / presumed to be compressing it. It often enough works, but it's no 100% thing. So, killing off potentially essential vessels in an attempt to remove a probable cause for another problem isn't the optimal approach. Might be considered as a second- or third-line therapy, but I'm not aware of that. But I'm neither a neurosurgeon nor an oral/maxillofacial specialist.

I quote from

[Begin quote]
Microvascular decompression provides:
  • Immediate, complete relief in 82 percent of current patients treated
  • Partial relief, requiring occasional or low-dose medication, in 16 percent of current patients treated
One year after surgery:
  • 75 percent of patients continue to enjoy complete pain relief
  • 8 percent have partial relief
Major complications occur in fewer than 5 percent of cases.
[End quote]

And this is the cushion technique. Just with a teflon pad instead of a bit of muscle...
I wasn't aware that muscle tissue could be used instead of the teflon. Wouldn't the body absorb something organic like its own tissue? So no way to promote growth of an artery in a different location in a way that directly causes the troubling one to shrink and disappear? In some cases an artery doesn't just bend into the trigeminal nerve. A person can be born with it completely wrapped around it. I just worry these really terrible diseases that are also rare will get very little funding towards research for treatments. I have a friend with ALS, a disease that most have heard of, and yet the amount of research isn't nearly enough to keep people alive much longer than 3 years.